| NPI | 1235567652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA J115080) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 115080) |
| 163W00000X Registered Nurse (Licence: IL 041375432) | |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2021-09-16 |